In a few of my recent posts, I’ve briefly mentioned the problem of good and bad information. For instance, there has been a great deal of paranoia and worry about the Internet in the last few decades. Thousands of studies have been conducted, and news reports delivered, about how we are being changed — and possibly harmed — by the massive, society-wide changes in the way we consume information. Many experts have agreed that the Internet is making us less focused, less capable of dedication to a single task, and possibly stupider. Whether these predictions are based on sound science or mere panic is hard to say, and only time will tell. I personally believe that the biggest change the Internet has wrought in society is not destroying the tools we use to solve problems, but rather to change the problems that we need to solve. When information only came from one source, or a very few — back when there were only three channels on TV — there was no meaningful choice between “good” information and “bad”. The information was what it was, and its flaws could not be changed or avoided. Nowadays, however, we are faced with the opposite problem — there is a huge overabundance of information, and we are free to pick and choose any of it that we like, to compare, to sort through and source it, to find its flaws and avoid them. The struggle of how to go about this sorting, and what principles are guiding it, is I think the defining question of the Information Age.
I wanted to explain this concept because it is related to how good medical science plays into addiction medicine. I’ve often said here that addiction, unlike many other fields, is not yet governed completely (or even mostly) by medical science and good research; huge swaths of it are still under the sway of opinion. This can take the form of individual counselors and clinicians making rules that only addicts can treat addicts, or it may manifest as opinion hallowed by time and tradition into a sort of law — the way it is in many 12-step programs.
Here, of course, we run into the problem of an overabundance of information. Everyone is entitled to their own opinion; those who have been affected by addiction certainly have the right to an opinion on what works best to help it, usually based on their own experience. The issue is that anyone affected by this disease who is trying to determine their own path must then sort through the wealth of opinions from ex-addicts, counselors, doctors, family members, and everyone else. Many of these opinions will be helpful; many will not. The issue we run into is how we determine whose opinion should count for more than others’.
Everyone is entitled to their opinion, but not all opinions should be given equal weight in a complicated decision like those that must be reached in disease management. Experience counts for a great deal, as does training.The idea that all opinions are equally true and hold equal weight can be damaging, and it can be used to hide deception and deceit. It’s easy for a snakeoil salesman to hide behind “but it’s just my opinion!” when he’s called out.
Here, again, I find it helpful to compare addiction to other medical specialties. In cardiology, the opinion of someone who’s had chest pain is not given as much weight as the opinion of a trained cardiologist, even if he’s never experienced chest pain himself. In addiction, opinions based on what often amounts to superstition are being used as the foundation for a system of healthcare. That needs to stop.
The principles by which each person filters information must of course be their own. One of the great advantages of standardized medicine, in my opinion, is that it creates a system in which better-founded ideas are given credence over more poorly-founded ones. I continue to work to create such a system in addiction. Once we solve this problem of information, care will be much more wide-reaching and effective.